We aimed to study racial differences in outcomes associated with status epilepticus (SE).

SE is a neurological emergency that is associated with significant morbidity and mortality. Factors such as etiology, duration and co-morbidities impact clinical outcomes. However, the impact of race on SE clinical outcomes is less understood. We utilized the NIS database, the largest publicly available database that collects nationwide information based on ICD-10 diagnosis codes, to evaluate racial differences in outcomes of patients with SE.

Data from 2016 to 2020 from the NIS database was retrospectively studied. SE patients were isolated using the ICD 10 code 40.911.  Race for each patient was recorded as White, Black, Hispanic, Asian or Pacific Islander, Native American or Other. Patient with missing or invalid entries were excluded. Outcome variables included mortality, length of stay and home discharges. All outcomes were adjusted for admission severity score. ANOVA and chi squared tests were used to analyze the impact of race on the outcome variables.

4577 patients were studied. 53.5% of the patients were white, while 23.2% of the patients were black. Asian or pacific islander, native Americans and others constituted 2.1%, 1.0% and 4.5% of the patients respectively. Black (OR 0.63, 95% CI 0.49-0.83; p-value <0.001) and hispanic patients (OR 0.48, 95%CI 0.34-0.68; p-value<0.001) had lower mortality when compared to white patients. There was no difference in length of hospital stay between the various groups. Hispanic patients had higher likelihood of home discharge when compared to white patients (OR 1.99, 95% CI 1.66-2.39; p-value<0.001). Native Americans (OR 2.08, 95%CI 1.11-3.89; p-value=0.022) and other racial origin (OR 1.58, 95%CI 1.16-2.14; 95%CI 1.16-2.14) patients also had higher likelihood of home discharge.

Identifying the causes of racial discrepancies in SE patients requires further research and can have a major population-level clinical impact.